Understanding Your Cellular Nutrition Assays A MESSAGE FROM OUR FOUNDER

My interest in food as medicine goes back almost 50 years. I spent a great deal of time outdoors in my youth and was enchanted by what I saw as the perfection and beauty of the natural world, which gave me the conviction that good quality food could create health and happiness; and conversely, poor quality food could slowly kill. That conviction eventually drew me to undertake the project of perfecting the method of the Alcat test, to identify which foods are good for any particular person and which are not. Food quality is essential; but, every bit as critical is the compatibility of the food for each and every individual.

That project began in 1986 and I have continued it to this day. For those of you who may not know, the Alcat test is an automated way to determine how an individual’s peripheral immune cells (i.e., live, white blood cells in the blood) react or do not react when confronted with a food, chemical, medicinal herb, drug; or, other substance. Testing is conveniently performed outside the body, that is, “ex vivo”.

This method was already confirmed in the 1930’s and 40’s through clinical studies conducted by allergists such as Theron Randolph, Herbert Rinkle, and others. Randolph, particularly, took lengthy and extensive histories on each of the patients that came to his Chicago practice during the 1930’s and concluded:

Usually, neither the patients nor their physicians have suspected food allergy as the root of their problem because most food allergy, by its very nature, is masked and hidden. It is hidden from the patient, hidden from his or her family, and hidden from the medical profession in general. It is said that often the solution to a difficult problem is right in front of your nose, but you cannot see it. In the case of food allergy, the source of the problem is literally in front of you, in the form of some commonly eaten substance that is bringing on and perpetuating chronic symptoms.*

*Please note that what Dr. Randolph referred to as, “food allergies” we now call food sensitivities, or, intolerances.

So, the concept and crude methodology for evaluation of leukocyte reactions to foods, ex vivo, already existed when I entered the field. What we did was automate the process, making it more reliable and built a structure to deliver it economically. I’m happy with the outcomes. Many hundreds of thousands of people from around the world have been profoundly helped by this technology. I cannot think of a better answer to our health care crisis than the implementation of this technology on a broader scale.

Along the way I heard about a lab that was doing something similar. They were looking at a sub set of white blood cells (the lymphocytes) to see if the specific memory cells would undergo a favorable proliferative response, when stimulated to do so, in the presence of different alterations of the micro-nutrient content (basically, vitamins, minerals, amino and essential fatty acids) in the culture medium, also ex vivo.

It should be mentioned that there are basically two broad types of immune system cells: innate immune cells, which are the first line of defense; and cells of the specific or “adaptive” branch of the immune system.

2 The Alcat Test for Food and Chemical Sensitivities looks at both categories; but, it is mainly the innate immune system cells that underlie food and chemical sensitivities. They are by far the more numerous, respond more quickly, and live for a shorter period of time. The specific immune cells, which are the lymphocytes, only become activated when the innate immune cells need an extra boost, be that through antibody production or the ability to directly kill infected cells. The specific immune cells are pathogen specific, meaning, they recognize only one pathogen, hence the name; and, are capable of dividing into exact replicas of themselves in order to buttress the attack. However, once the threat has passed, they go back to their resting state and reduce in number. Their ability to divide or “proliferate” determines how quickly we quell the pathogen next time it comes around. And that ability to do so is dependent upon its intracellular nutrient stores. Hence, measurement of cell proliferation, when stimulated to do so (by a mitogen, i.e., “mitosis generator) can provide a functional measurement of not only the lymphocytes’ respective individual micronutrient stores but also reflect the nutritional status of all somatic cells.

I found this approach fascinating and I learned that the inventor of this test, William Shive, worked at Experimental Sciences, University of Texas in Austin. Since I lived in Austin I reached out to see if he would entertain a visit. We met shortly thereafter and had numerous follow up meetings to discuss how our methods of cellular measurement might improve his assay; and, toward that end, we began collaboration. This continued until Dr. Shive’s untimely death. We have since continued our efforts over the past 20 years and have finally succeeded in bringing about a test that is broader, less time consuming, more accurate, and more economical. We hope you find it beneficial.

For this I honor the important pioneering work performed by Dr. Shive and his collaborators and am grateful for the extraordinary achievements of my research and nutrition teams, and thank them for their untiring work.

Roger Deutsch, CEO Cell Science Systems, Corp.

N.B. I still strongly believe in meeting our nutritional requirements through consumption of wholesome, fresh, organically produced food; however, in today’s world one may greatly benefit by taking appropriate supplements; and, this test can offer valuable guidance as to which supplements to take.

The Alcat Test for Food and Chemical Sensitivities and the Alcat method for assessment of micronutrient deficiencies, go hand in hand. They both measure a different functional response of the immune system; one test telling you what not to eat and the other telling you what you should eat.

However, some gastrointestinal disorders can impair absorption of nutrients, even if adequately consumed. For this reason we have created a test panel to assess genetic risk for Celiac and Crohn’s, along with markers to assess current disease states. It’s called the CICA (Celiac, IBS, Crohn’s Array) and can be ordered along with an Alcat test at a reduced cost.

3 TABLE OF CONTENTS

Understanding Your Cellular Micronutrient Assay Test Results ...... 5

How the CMA Works ...... 7

The CMA Results Report ...... 8

Micronutrients Tested in the CMA ...... 9

Amino Acids ...... 9

Vitamins ...... 13

Minerals ...... 16

Nutrients ...... 20

Understanding Your Redox Assay Results ...... 24

Understanding Your Antioxidant Protection Assay Results ...... 25

Antioxidant Protection Assay (APA) ...... 26

Antioxidant Nutrients Tested in the APA ...... 27

Botanicals & Phytonutrients Tested in the APA ...... 32

References ...... 39

4 Understanding Your Cellular Micronutrient Assay Test Results

Why Assess Micronutrient Status?

Nutrients are vital to health. They are required for every metabolic process in the body including:

• Energy generation

• Production of cells, tissues, organs, bones, genetic material, and teeth

• Protective mucous membranes

• Immune cells function and structures

• Synthesis of important compounds such as neurotransmitters, enzymes, hormones, and other functional proteins

Essential nutrients—vitamins, minerals, trace elements, water, phytonutrients, amino acids, and essential fatty acids— must be obtained from what we ingest. We must obtain these nutrients from food or in supplement form because the human body cannot produce them at all or in quantities sufficient to meet metabolic needs.

In order to promote optimal health, assessing nutrient status regularly is key to understanding what to address regarding the ideal dietary intake for an individual.

Metabolism and all biochemical reactions take place intracellularly (within cells). Nutrients- vitamins, minerals, amino acids, and fatty acids are utilized within cells to produce energy and to manufacture enzymes, hormones, neurotransmitters, and proteins in order to sustain life. Micronutrients in particular—vitamins, minerals, and phytonutrients— are the driving force or the “spark” behind these metabolic reactions. An insufficiency of any of the nutrients involved can contribute to a disruption in cell metabolism.

5 Cellular Micronutrient Assay (CMA)

Functional cellular nutrient analysis assesses the impact of individual nutrients on cellular function. The CMA (Cellular Micronutrient Assay) directly measures the effect of specific micronutrients on the ability of T and B lymphocytes to reproduce when stimulated with a mitogen (an agent that causes mitosis/cell division). When the body has an infection, it increases production of the T and B lymphocytes (memory cells) that “recognize” and combat that specific invader. The faster these cells reproduce the faster infection is overcome. The ability of these cells to multiply is driven by our nutrient stores. Cells need nutrients in order to grow and multiply. Those nutrient requirements are unique to each individual and are impacted by many factors. Stress, genetics, high energy output in sports, pregnancy, recent infection, toxic burden, sleep patterns, etc., all play a role.

Intracellular vs. serum and plasma assessment ​Measurement of micronutrients in plasma or serum is a reflection of their levels in circulation and outside of cells, not a reflection of nutrient levels within the cell where they have the most functional impact. ​​Serum/plasma levels of nutrients are prone to daily fluctuations ​and are not necessarily a complete and perfect indication of intracellular nutrient status. Therefore, assessing micronutrients and their impact on cellular function at the cellular level is preferred as it provides insight into an individual’s long-term nutritional status (6 months) versus short-term variability.

6 Cellular Micronutrient Assay (CMA) How the CMA Works

√ Lymphocytes are separated from the patient’s whole blood.

√ The patient’s own serum is then added back to the lymphocytes.

√ Cells are stimulated with a mitogen (mitosis generator) and baseline proliferation rates are determined. The lymphocytes’ growth rate stimulated by the mitogen (as determined by intracellular metabolic activity) without the addition of micronutrients, is defined as the patient’s baseline.

√ Micronutrients are added to the lymphocytes/culture one at a time. Proliferation rates (metabolic activity) after nutrient additions are compared to the patient’s baseline proliferation rate. The single independent variable is the presence of a specific micronutrient and in this way it is determined if that specific micronutrient enhances proliferation and to what degree.

√ The nutrients that enhance the cellular functional response to the mitogenic stimuli are reported as a nutrient insufficiency and borderline nutrition insufficiency. The enhancement of the mitogen-induced proliferation rate (marked or moderate response) indicates a suboptimal quantity of that particular nutrient within the patient’s cells, and an “insufficiency/borderline insufficiency” of that nutrient.

7 Cellular Micronutrient Assay (CMA) The CMA Results Report

Nutrient Insufficiency

Borderline Nutrient Insufficiency

Nutrient Sufficiency (No Proliferation)

The proliferation rate after an addition of each individual micronutrient is reported as a % of the patient’s baseline proliferation rate.

A Nutrient Insufficiency means that the cells’ proliferation rate was 120% or greater of the patient’s baseline cellular proliferation rate. The significant increase in metabolic activity and optimal function, very likely indicates insufficient functional stores of the nutrient responsible for the increased proliferation rate.

A Borderline Nutrient Insufficiency means that the cells’ proliferation rate was between 110-119% of the patient’s baseline cellular proliferation rate. The moderate increase in metabolic activity and function indicates probable borderline insufficient functional stores of the nutrient responsible for the increased proliferation rate.

Nutrient Sufficiency means that the cells’ proliferation rate was not above the patient’s baseline cellular proliferation rate, likely indicating sufficient functional stores of the nutrient added.

8 Micronutrients Tested in the CMA Amino Acids

In the pages that follow, you will find descriptions of the nutrients tested in the Cellular Micronutrient Assay, their important functions, and foods that are considered good sources of them. Please keep in mind that overt deficiencies of these nutrients are not common in Western societies. However, insufficient micronutrient status or subclinical deficiencies are, in fact, commonplace.

The descriptions that follow are for educational purposes only. Statements are not to be interpreted as treatment recommendations and do not take the place of advice from a qualified practitioner. Please be aware that botanicals and high doses of certain nutrients may interact with medications, botanicals, and medical diagnoses, and therefore may be contraindicated. The patient is encouraged to seek guidance and an individualized food and supplement plan from a qualified nutrition practitioner. Amino Description Important for May be useful Good Food Sources Acid for prevention/ treatment of Arginine L-arginine is an amino • Vasodilation – dilatation anal fissure, meat, poultry, fish, dairy (L-Arginine) acid, a building block for and relaxation of blood congestive heart products, peanuts, nuts, protein synthesis, and is vessels failure, erectile seeds, whole grains, best known for its effects • Wound healing and dysfunction, pre- legumes, and chocolate. on the vascular system. enhancement of the eclampsia, sickle cell immune system disease, esophageal • Ammonia detoxification spasm, infertility, interstitial cystitis, and Raynaud's disease Asparagine L-asparagine is a non- • Energy production fatigue poultry eggs, dairy, fish, (L-Asparagine) essential amino acid Brain and nervous meat, nuts, seafood, seeds, required for the synthesis system function potatoes, asparagus, soy, of many important cellular • Metabolism of ammonia and whole grains proteins and other amino acids. Cysteine L-cysteine is classified as • Protein synthesis Alzheimer’s disease, beef, pork, chicken, (L-Cysteine HCL) a “semi-essential” amino • Support of the Parkinson’s disease, sunflower seeds, walnuts, acid manufactured from synthesis of glutathione, arthritis, poor and soy methionine. It is made the body’s “master intestinal health, in small amounts by the antioxidant” dementia, multiple liver, but the availability of • Immune support sclerosis, male methionine is necessary. • Lipid metabolism infertility, and • Digestive support osteoporosis • Vascular support • Antioxidation • Anti-inflammation • Nerve protection • Detoxification Glutamine Glutamine is the most • Protein, DNA, RNA, acquired meat, chicken, fish, cheese, (L-Glutamine) abundant free amino acid and neurotransmitter immunodeficiency milk, yogurt, legumes, and in the body, it is produced synthesis syndrome, alcohol lentils primarily in skeletal • Fuel source cells that addiction, burns, muscle and released into line the small intestine gastroenteritis the circulation. • Fuel source for pancreatitis, and immune cells, such as peptic ulcer, and for macrophages preventing infections • Maintaining nitrogen following intense balance exercise • Preventing the burning of other amino acids for energy

9 Micronutrients Tested in the CMA Amino Acids

Amino Description Important for May be useful Good Food Sources Acid for prevention/ treatment of Glycine Although not considered • Collagen formation • Schizophrenia gelatin, protein rich foods “essential” because it • Heme synthesis • Stroke including meat, fish, dairy, is made from serine, • Detoxification • Seizures and legumes glycine is considered a • Glutathione synthesis • Memory and conditionally essential • Energy source/synthesis cognitive amino acid because of glucose performance in there are many metabolic • Brain neurotransmitter psychosis risk demands for it- including effect/CNS function syndrome • Anti-cancer heme biosynthesis, • Cystic fibrosis • Antioxidation collagen formation, and • Gout its role in digestion, • Insomnia detoxification and • Venous leg neurotransmitter action. ulcers • Certain types of cancer Histidine Histidine, an essential • Protection of nerve cells rheumatoid arthritis, beef, lamb, pork, poultry, amino acid, is involved in • Metabolism of the allergic diseases, fish, cheese, nuts, seeds, a wide range of metabolic neurotransmitter, ulcers, and anemia eggs, legumes, soybeans, processes in the body, histamine caused by kidney quinoa, and whole grains. and is needed for growth • Immune, gastric, and failure or kidney and tissue repair. sexual function dialysis • Manufacturing of red and white blood cells • Protection of tissues against radiation and heavy metals Isoleucine Isoleucine is a branched • Blood clotting anorexia, mania, meat, fish, eggs, nuts seeds, (L-Isoleucine) chain amino acid Muscle and tissue repair tardive dyskinesia, lentils, peas, soy important for energy • Energy production prevention of production and tissue • Protein synthesis muscle breakdown repair. Regulation of blood during exercise, and glucose exercise fatigue Leucine Leucine is a branched • Regulation of blood muscle soreness and meat, dairy, nuts, legumes, chain amino acid effective glucose fatigue from exercise, eggs, brown rice, soybeans, at inducing insulin release • Growth hormone muscle wasting, whole wheat from the pancreas and production atherosclerosis, and providing energy during • Fuel for the body obesity exercise. It is one of the • Protection, repair, body's nine essential recovery of muscle amino acids. Lysine Lysine is an essential • Building muscle protein recurring herpes meat, fish, poultry, amino acid that plays • Increasing collagen simplex infections/ dairy, eggs, soybeans, an important role in the production and tissue cold sores, diabetes, and legumes. Note: a production of enzymes repair high triglycerides, and significant amount of lysine and hormones, as well • Supporting the stress is destroyed by harsh as the growth and production of enzymes, cooking techniques like high development of bones antibodies, and temperature baking, grilling, and muscles. hormones and frying. • Promoting calcium absorption • Immune support

10 Micronutrients Tested in the CMA Amino Acids

Amino Description Important for May be useful Good Food Sources Acid for prevention/ treatment of Methionine Methionine is an essential • The support of pancreatitis, Brazil nuts, meat, poultry, amino acid that is detoxification of toxins Parkinson’s disease, fish, yogurt, cheese, eggs, involved in the synthesis and heavy metals urinary tract legumes, soybeans, sesame of important protein • Antioxidant function infections, and diaper seeds, and grains molecules and other • Digestive support rash amino acids. • The availability of folate • The support of healthy liver function • Reduction of histamine in blood • Exercise recovery, connective tissue production, and cardiovascular health • Hair and nail strength Phenylalanine Phenylalanine is an • Mood and appetite depression, attention meat, seafood, eggs, cheese, essential amino acid regulation deficit-hyperactivity milk, peanuts, pumpkin used by the body to • Mental function disorder (ADHD), seeds, bananas, whole produce proteins and • Pain tolerance Parkinson's disease, grains, brewer’s yeast, neurotransmitters. chronic pain, almonds, corn, avocados osteoarthritis, rheumatoid arthritis, alcohol withdrawal symptoms, and vitiligo Serine L-serine is a nonessential • Synthesis of proteins schizophrenia, meat, poultry, fish, legumes, (L-serine) amino acid that is and neurotransmitters Parkinson’s disease, soybeans synthesized from the • Metabolism of fats depression, amino acid, glycine. It is • Muscle formation fibromyalgia, and especially important to • Healthy cognition chronic fatigue proper functioning of the • Formation of syndrome. brain and CNS. phospholipids for every cell in the body • Formation and maintenance of myelin sheath- protecting nerve cells • RNA and DNA function • Maintenance of a healthy immune system Taurine Taurine is a sulfur- • Protection of cell congestive heart The main dietary sources containing non-essential membranes failure, diabetes, of taurine are animal foods amino acid important in • Hydration and cirrhosis, NAFLD, such as fish, meat, and dairy. the metabolism of fats. electrolyte balance in myotonic dystrophy, cells and retinitis • Detoxification and pigmentiosa antioxidant function • Formation of bile salts, which play an important role in digestion • Cardiac contractility • Immune health • Growth and development of the central nervous system 11 and eyes Micronutrients Tested in the CMA Amino Acids

Amino Description Important for May be useful Good Food Sources Acid for prevention/ treatment of Threonine Threonine is an essential • Nervous system function ALS, exercise capacity cottage cheese, watercress, amino acid used as a • Digestion in congestive heart sesame seeds, nuts, building block for proteins. • Fat metabolism in the failure, pain, disability, legumes, soy, meat and fish, liver and spasticity in MS lentils, eggs, dairy products • Formation of collagen , tooth enamel, health of the skin • Immune function Tryptophan L-tryptophan is an • Serotonin synthesis Premenstrual Animal proteins contain the essential amino acid. • GI support- regulation of dysphoric disorder highest concentrations of The body absorbs motility (PMDD), smoking tryptophan, oats, bananas, tryptophan from dietary • Blood glucose support cessation, anxiety, dried prunes, milk, tuna protein, converts it to • Neurotransmitter bipolar disorder, fish, cheese, bread, chicken, 5-hydroxytryptophan balance- mood and cognitive impairment, turkey, peanuts, and which is then converted sleep support depression, insomnia, chocolate, eggs, spirulina, to serotonin. Tryptophan migraine, obsessive- sesame seeds, beans, absorption into the brain compulsive disorder, potatoes. Consumption of is influenced by dietary pain, restless legs carbohydrate may enhance intake. syndrome,gout,H- tryptophan availability to pylori,sleep apnea, cross the blood brain barrier. seasonal affective NOTE: Supplementing with disorder. tryptophan and 5 HTP is contraindicated in patients taking SSRI medications. Tyrosine Tyrosine is a non-essential • Building block for depression, poultry, fish, avocados, amino acid that is protein synthesis ADHD, cognitive almonds, cheese, milk, synthesized in the body • Synthesis of the brain performance and yogurt, bananas, soybean, from an essential amino chemicals, dopamine, memory, narcolepsy, legumes, nuts, seeds, and acid, phenylalanine. norepinephrine, and acute stress, alcohol, some grains epinephrine heroine, and cocaine • Regulation of mood, withdrawal appetite, pain sensitivity • Thyroid, adrenal, and pituitary function Valine Valine is one of the three • Growth and tissue stress, anxiety, dairy products, meat, branched chain amino repair, muscle health appetite regulation, fish, nuts, seeds, lentils, acids (BCAAs). • Energy production and alcohol related mushrooms, sesame seeds, • Blood glucose regulation brain issues soy protein, leafy greens, • Support of the CNS and and whole grains. cognition • Support of detoxification • Immune function

12 Micronutrients Tested in the CMA Vitamins

Vitamin Description Important for May be useful for Good Food Sources prevention/treatment of

Biotin (Vitamin Biotin is an essential B vitamin • The conversion of diabetes, brittle nails, meat, fish, egg yolks, B7) also known as vitamin B7. carbohydrates, proteins and seborrheic dermatitis of liver, poultry, dairy fats into energy. infancy, MS, and uremic products, seeds, • Health of skin, nails, eyes, neuropathy nuts, sweet potatoes, liver, and nervous system. spinach, and broccoli Cobalamin Vitamin B12 is a group of • DNA (genetic material) issues of the skin, vitamin B12 is found (Vitamin B12) compounds called cobalamins. synthesis ears/nose/throat, almost exclusively in • Red blood cell formation issues associated with animal products- meat, • Nervous system and immune aging, and certain poultry, fish, eggs, and system function conditions/disorders dairy products. Beef • Metabolism of homocysteine of the cardiovascular, liver and clams are gastrointestinal, the highest sources. musculoskeletal, immune, B12 fortified breakfast and nervous systems cereals and nutritional yeasts. Delta gamma Delta tocotrienol is a natural form • Antioxidation hyperlipidemia, certain palm oil, rice bran , tocotrienol of vitamin E. Vitamin E is a group • Antiaging types of cancer, annatto seeds. The of eight fat soluble compounds • Anti-inflammatory atherosclerotic heart most potent source, that include four tocopherols • Anticancer disease, metabolic annatto beans/ (alpha, beta, gamma and delta) and four tocotrienols (alpha, beta, • Brain health syndrome. NAFLD, pods are not edible gamma, and delta). Studies suggest • Bone health Parkinson’s disease, but supplemental that tocotrienols can provide • Cardiovascular effects osteopenia/ osteoporosis sources often derive health benefits distinct from alpha- • Prevention of platelet tocotrienols from tocopherol, the most well known aggregation the annatto bean. form of vitamin E. Tocotrienols • Hypolipidemic effects Supplementation is have greater fluidity which makes it • Neuroprotective effects normally necessary. easier for the body to incorporate them into cell membranes, especially delta-tocotrienol.

Folate (Vitamin Vitamin B9, more commonly • Growth and development Alzheimer’s disease, spinach and other B9) known as folate (naturally- • Homocysteine and vitamin cardiovascular leafy greens, green occurring form of B9) or folic B12 metabolism disease, homocysteine vegetables, beets, acid (a synthetic form), is a • Brain and CNS function lowering,anemia, banana, melon, water-soluble vitamin that is • Immune system function migraines, restless legumes, yeast, part of the B vitamin family. • Cardiovascular support legs, dermatitis, autism, mushrooms, oranges • Red blood cell production depression, cognitive and tomato juice. • Reproductive health decline/dementia, age-related macular degeneration, birth defects, diarrhea, hearing loss, osteoporosis, cervical dysplasia, ulcerative colitis, and recurrent miscarriages Nicotinamide Vitamin B3 occurs naturally in • Conversion and release of certain cardiovascular, meat, chicken, fish, (Niacin, Vitamin two forms, niacin (aka nicotinic energy from carbohydrate, dermatological, and whole grains, nuts, B3) acid) and niacinamide (aka protein, and fat psychiatric issues as well legumes, and dairy nicotinamide). All the body’s • Brain function as disorders in hearing, products tissues convert niacin into • Influence on serum lipid olfactory, taste, addictions, its active form, nicotinamide levels (niacin form only) osteoarthritis, ADHD, and adenine dinucleotide which is • Regulation of blood glucose insomnia required for more than 400 (niacin form only) enzymes to drive metabolic processes. 13 Micronutrients Tested in the CMA Vitamins

Vitamin Description Important for May be useful for Good Food Sources prevention/treatment of

Pantothenic Pantothenic acid, also called • Metabolism of carbohydrate, acne vulgaris, allergic meat, chicken, organ Acid vitamin B5, plays a vital role in protein, and fat rhinitis, and adrenal meats, whole grains, (Vitamin B5) converting food to energy. • Synthesis of cholesterol insufficiency legumes, and some • Digestion vegetables • Immune function Pyridoxine Pyridoxine helps convert food • Metabolism of fats and atherosclerosis, hair loss, poultry, fish, organ (Vitamin B6) into fuel and is a cofactor proteins acne, Meniere’s disease, meats, potatoes, for more than 50 different • Nerve function taste disorders, vertigo, banana, seeds, enzymes. • Steroid hormone function neurological conditions, soybeans, spinach, • Arterial integrity gestational diabetes, whole grains, legumes • Immune function premenstrual syndrome, • Synthesis of niacin from anxiety, ADHD cognitive tryptophan decline, depression, and • Breakdown of homocysteine possibly some protection from certain toxin induced issues Riboflavin Vitamin B2, or riboflavin, is an • Normal cell function, growth and migraines, Parkinson’s disease, turkey, sardines, eggs, (Vitamin B2) essential vitamin involved in development hyperhomocysteinemia, and legumes, soybeans, vital metabolic processes. It • Metabolism of carbohydrate, psoriasis broccoli, cauliflower, is a component of two major protein, and fat for energy Brussels sprouts, coenzymes flavin mononucleotide production peppers, root vegetables, (FMN-aka riboflavin-5-phosphate) • Cofactor needed to produce and squash and flavin adenine dinucleotide glutathione, a very important (FAD). antioxidant • Homocysteine metabolism • Promotes iron metabolism • Metabolism of steroids and certain drugs Thiamine Vitamin B1, thiamin, or thiamine • As a cofactor for enzymes that epilepsy, Parkinson’s disease, Whole grains, meat, fish (Vitamin B1) functions plays an important role play a role in energy production sciatica, back pain, CHF, in energy metabolism, growth, • Support of the nervous system, cognitive decline, diabetes, development, and function of cells. muscles, heart, brain, and fibromyalgia, and hepatitis digestive system.

Vitamin A Vitamin A is a broad group of • Growth and development acne, eczema, warts, wrinkles, dairy products, shrimp, fat soluble retinoids, including • Immune function hearing loss, olfactory eggs, salmon, halibut, retinol, retinal, retinoic acid, retinyl • Vision dysfunctions, certain scallops, sardines, esters and several provitamin • Maintenance of epithelial and infectious diseases, night tuna, cod, and chicken. A carotenoids (example, beta mucosal tissues –skin, GI tract, blindness, conjunctivitis, Sources of provitamin A carotene). respiratory tract, conjunctiva, bronchopulmonary dysplasia, carotenoids (converted There are two forms of vitamin A: nose and genitourinary tract burns, cancer, diabetes, peptic in the body to vitamin retinoids (found in animal foods) • Cell to cell communication ulcer, and more A) include carrots, and carotenoids (found in plant • Reproduction spinach, sweet potato, foods) • Antioxidant and anti- kale, greens, cantaloupe, inflammation and other fruits and vegetables. Vitamin C Vitamin C (ascorbic acid) is a water • Antioxidation allergic rhinitis,asthma, citrus fruits, raspberries, soluble vitamin that is essential for • Anti-inflammation cardiovascular issues, certain strawberries pineapple, human survival. • Immune function types of cancer, cold and kiwi, cantaloupe, greens, • Blood vessel formation flu, GI issues- constipation, cruciferous vegetables- • Muscle formation gallstones, gastritis, UTIs, Brussels sprouts, • Collagen production muscle cramps, dysfunctional broccoli, squash, green • Brain Health/neurotransmitter uterine bleeding, glaucoma, beans, carrots, potatoes, production depression, diabetes, tomatoes, peppers • Absorption of iron obesity, post exercise muscle • Blood lipid regulation soreness, and sinusitis • Detoxification

14 Micronutrients Tested in the CMA Vitamins

Vitamin Description Important for May be useful for Good Food Sources prevention/treatment of

Vitamin D Vitamin D, known as the "sunshine" • Calcium absorption in the gut eczema, colds, hepatitis C, oily fish -salmon, vitamin, is a fat soluble vitamin • Bone development, bone osteomalacia/osteoporosis, sardines, herring, produced by the body in response mineralization, bone health asthma, burns, cancer, CHF, mackerel, and tuna, cod to sun exposure; it is naturally • Regulation of serum calcium and Crohn’s disease, depression, liver oil , fortified milk, present in few foods. It functions phosphorous levels diabetes ,fatigue, Parkinson’s eggs, liver as a prohormone. • Neuromuscular and immune disease, PCOS, lupus, and function and maturation of white more blood cells • Cell growth • Enhancement of insulin secretion/action • Reduction of inflammation Vitamin K1 Vitamin K is a general name of • Regulation of blood clotting atherosclerosis/ ischemic green tea, leafy greens a family of compounds with a • Transport of calcium and bone heart disease, nausea such as kale, turnip common chemical structure- metabolism hemorrhagic disease of greens, and spinach, Vitamin K1 (phylloquinone • Potential antioxidant protection, newborns, vomiting of broccoli, Brussels sprouts, or phytonadione), vitamin K2 and insulin sensitivity support, pregnancy, and osteoporosis asparagus, cabbage, (menaquinone), and vitamin K3 protection of cells lining blood other vegetables. (menadione- no longer used in vessels fortified foods/supplements). Vitamin K1 is the primary source of vitamin K that humans obtain through foods. Vitamin K2 Vitamin K is a general name of • Regulation of bone beta-thalassemia, rheumatoid dietary vitamin K2 is (MK4) a family of compounds with a demineralization arthritis, cirrhosis, hepatitis, found in some fermented common chemical structure- • Directs calcium deposits to myelodysplasia, cardiovascular foods (ie, natto, cheese) Vitamin K1 (phylloquinone bones instead of soft tissue issues, osteoporosis, where the specific or phytonadione), vitamin K2 • Anti-inflammation Alzheimer’s disease, cognitive menaquinone compound (menaquinone), and vitamin K3 • Anticoagulation decline, wrinkles, diabetes, that is formed depends (menadione- no longer used in • Antioxidation metabolic syndrome, arthritis, on the bacterial species fortified foods/supplements). • Supports bone growth and neurological issues, certain and fermentation Vitamin K2 is a group of development types of cancer, kidney conditions. So not all compounds which are classified • Supports cardiovascular health disease, kidney stones, fermented foods have according to their chemical • Insulin sensitivity, energy PCOS, anxiety, depression, the same menaquinone structures- MK4 through MK13. utilization postmenopausal bone loss, profile. An individual's MK4, MK7, and MK9 are the most and cavities dietary intake of vitamin well studied menaquinones. K2 can vary greatly Menaquinones, mostly originating based on food selection from bacteria, are present and geography. MK4 is in various animal based and typically found in eggs, fermented foods. Menaquinones grass-fed meat, chicken, are also produced by bacteria in soft cheese, butter, liver the gut. MK4 is produced from (goose, chicken) chicken vitamin K1 (phylloquinone). Vitamin K2 Vitamin K is a general name of • Regulation of bone beta-thalassemia, rheumatoid Dietary vitamin K2 is (MK7) a family of compounds with a demineralization arthritis, cirrhosis, hepatitis, found in some fermented common chemical structure- • Directs calcium deposits to myelodysplasia, cardiovascular foods (ie, natto, cheese) Vitamin K1 (phylloquinone bones instead of soft tissue issues, osteoporosis, where the specific or phytonadione), vitamin K2 • Anti-inflammation Alzheimer’s disease, cognitive menaquinone compound (menaquinone), and vitamin K3 • Anticoagulation decline, wrinkles, diabetes, that is formed depends (menadione- no longer used in • Antioxidation metabolic syndrome, arthritis, on the bacterial species fortified foods/supplements). • Supports bone growth and neurological issues, certain and fermentation Vitamin K2 is a group of development types of cancer, kidney conditions. So not all compounds which are classified • Supports cardiovascular health disease, kidney stones, fermented foods have according to their chemical • Insulin sensitivity, energy PCOS, anxiety, depression, the same menaquinone structures- MK4 through MK13. utilization postmenopausal bone loss, profile. An individual's MK4, MK7, and MK9 are the most and cavities dietary intake of vitamin well studied menaquinones. K2 can vary greatly based Menaquinones, mostly originating on food selection and from bacteria, are present geography. MK7 is found in various animal based and in natto, fermented soy fermented foods. Menaquinones foods are also produced by bacteria in 15 the gut. Micronutrients Tested in the CMA Minerals

Mineral Description Important for May be useful for Good Food Sources prevention/treatment of

Boron Boron is a trace mineral • Bone formation/health dysmenorrhea, osteoarthritis fruit, vegetables, tubers, that is not yet classified • Mineral, calcium metabolism (preliminary evidence), and legumes. Prune juice, as an essential nutrient • Membrane function osteoporosis (preliminary avocado, raisins, peaches, for humans but is gaining • Synthesis of steroid hormones evidence), prostate, cervical, and grape juice, apples, pears, acceptance as one. (estradiol, testosterone, lung cancer, and age-related peanuts, , peanut butter, dehydroepiandrosterone, and cognitive decline (preliminary refried beans, grapes, 1,25-dihydroxyvitamin D. evidence). Topically, boric acid, oranges, lima beans. • Reproduction and development the most common form of • Brain function boron, is used as an astringent, • Antimicrobial to prevent skin infection, and • Antioxidation as an ophthalmological irrigant. • Insulin and energy substrate Another form of boron, sodium metabolism pentoborate pentahydrate, • Immunity is used to prevent radiation dermatitis (preliminary evidence). Intravaginally, boron is used for vaginal candidiasis Calcium Calcium is a mineral • Strength of bones and teeth brittle nails, leg cramps in milk, yogurt, cheese, kale, essential for good health. • Muscle tone and contraction pregnancy, pre-eclampsia, broccoli, Chinese cabbage, The most abundant mineral • Cardiovascular and nervous obesity, osteoporosis, PMS, and collard greens, mustard in the body, almost all system function periodontal disease. greens, turnip greens, calcium (99%) is stored in Absorption of protein and fat salmon and sardines bones and teeth where it • The release of hormones and canned with bones, supports their strength. The enzymes that impact almost calcium fortified tofu, body uses this reservoir to every function in the body sesame seeds, blackstrap maintain a tightly regulated • Cellular communication molasses calcium blood level. • Tissue repair • pH balance Chromium Chromium is a mineral • Insulin function bipolar disorder, dementia/ The content of this required by humans in trace • Antioxidation cognitive decline, diabetes/ mineral in foods is amounts. • Serotonin function gestational diabetes, metabolic substantially ijmpacted • Carbohydrate, protein, and fat syndrome, depression, by agricultrual and metabolism hyperlipidemia, PCOS, reactive manufacturingprocesses. hypoglycemia whole grains- oats, barley, eggs, brewer’s yeast, beef, chicken, bananas, lobster, shrimp, mushrooms, broccoli,green beans, tomatoes, Romaine lettuce, and cheese Copper Copper is an essential trace • Red blood cell formation (along aortic aneurysm, burns, organ meats, seafood, mineral found in all body with iron), anemia prevention osteoporosis, peptic ulcer, RA, and nuts, especially cashews tissues. • Myocardial contractility disorders of taste and walnuts, seeds, • Maintenance of the health of especially sesame and blood vessels, nerves sunflower seeds, legumes, • Immune support, wound lentils. soybean, shiitake healing mushrooms, greens, • Generation of energy from asparagus, summer carbohydrate squash, wheat-bran • Antioxidation (cofactor for SOD- cereals, and whole-grains superoxide dismutase) and cocoa. • Anti-inflammation support • Bone and tissue integrity • Cholesterol and glucose regulation

16 Micronutrients Tested in the CMA Minerals

Mineral Description Important for May be useful for Good Food Sources prevention/treatment of

Iodine Iodine is an essential • Thyroid hormone production if deficient in iodine- hearing, sea vegetables, fish and component of the thyroid • Essential for growth hypothyroidism, and improvement seafood, iodized salt, dairy hormones, triiodothyronine • Metabolism in cognition. If not deficient products, eggs. (T3) and thyroxine (T4), • Protein synthesis iodine may be useful for treating essential to control energy • Skeletal and CNS development fibrocystic breast changes, cyclical production/utilization in just mastalgia, and hyperthyroidism about every cell in the body. Iron Iron is a mineral found in • Oxygen transport ADHD, cognitive decline/ iron exists in foods in two trace amounts in every cell • Growth and development dementia, fatigue, infertility, and forms, heme iron and in the body. Most of the • Immune activity restless leg syndrome. nonheme iron. The richest iron in the body is found • Energy production and sources of heme iron are in the hemoglobin of red metabolism oysters, liver, lean red beef, blood cells that carries • Hormone, neurotransmitter, poultry, tuna, and salmon. oxygen from the lungs to and DNA synthesis Non-heme iron is harder the tissues of the body and for the body to absorb. in myoglobin, a protein Sources of non-heme providing oxygen to muscles. iron are legumes, whole It also functions in several grains, nuts, dried fruit, key enzymes in energy and greens. Consuming production and metabolism, these foods with vitamin including DNA synthesis. C rich foods and/or heme sources of iron, enhances the absorption of nonheme iron. Lithium Lithium is a trace mineral • Modulation of the nervous bipolar disorder, depression, depending on geographical that is present in the system function schizophrenia, impulsive location due to uneven diet, mainly in grains and • Modulation of neurotransmitter aggressive behavor associated distribution of lithium in vegetables. Some people activity- GABA, serotonin, with ADHD. the earth’s crust: cereals, use lithium supplements as melatonin potatoes, tomatoes, medicine -lithium is available • Modulation of circadian rhythms cabbage, and some as an FDA approved • May be required for normal mineral waters. It may also prescription medication for metabolism and neural be found in some spices use in psychiatric conditions. communication such as nutmeg, coriander Supplements contain much seeds, or cumin. Small smaller quantities than amounts also found in prescribed medication. foods from animal origin like sardines and egg yolks. IMPORTANT: Lithium interacts with a number of herbs, supplements, medications, and medical conditions. Lithium supplementation should only be used with guidance and monitoring by a qualified practitioner. Magnesium Magnesium is an essential • Structural integrity of teeth and angina, arrhythmias, CHF, spinach, Swiss chard, mineral, a cofactor in more bones Energy, DNA, RNA, and hypertension, stroke, brittle beet greens, turnip than 300 cellular reactions, protein synthesis Essential fatty nails, Meniere’s disease, olfactory greens, summer squash, and necessary for the acid metabolism issues, gastrointestinal issues, pumpkin seeds, sesame synthesis of energy. • Glutathione (antioxidant) constipation, fibromyalgia, seeds, sunflower seeds, synthesis headaches, migraines, muscle cashews, almonds, barley, • Immune support cramps (especially nocturnal), buckwheat, brown rice, • Transport of calcium and anxiety, depression, cognitive quinoa, millet, wheat germ, potassium ions across cell decline, fatigue,menstrual cramps, kidney beans, soybean membranes PMS, and glucose tolerance. flour, tofu. • Muscle contraction and nerve function • Regulation of heart rhythm • Regulation of blood glucose • Blood pressure regulation • Regulation of stress response 17 Micronutrients Tested in the CMA Minerals

Mineral Description Important for May be useful for Good Food Sources prevention/treatment of

Manganese Manganese is an essential • Metabolic and enzymatic osteoporosis, epilepsy, tardive cloves, whole grains, tea, mineral which plays a role in reactions to process dyskinesia, and sexual dysfunction nuts, seeds, legumes, and the production of cartilage carbohydrate, amino acids, and in females. leafy green vegetable, and bone matrix. Although cholesterol cinnamon, berries, garlic, important for maintaining • Bone and cartilage health and basil good health, manganese can development be toxic at high levels. Antioxidant function • Wound healing • Collagen formation Molybdenum Molybdenum is an essential • The breakdown of toxic asthma, chronic aches and pains, legumes, lentils, nuts, trace mineral. It serves substances sulfite and chemical sensitivities, grains, cheese, organ mainly as a cofactor for over • Antioxidation and anti- allergies, insomnia, tooth decay, meats 50 enzymes and aids in the inflammatory support MS, lupus, eczema, and gout. metabolism of proteins and • Liver and digestive support the production of genetic materials. Humans need only very small amounts of molybdenum, which are easily attained through a health promoting eating pattern. Potassium Potassium is a mineral • Muscle and nerve activity • Atherosclerosis/ischemic Obtaining potassium from and the most abundant • Regulation of blood pressure heart disease foods is preferred, so be intracellular cation. It helps • Fluid balance • Congestive heart failure sure to discuss dietary regulate fluid balance as • Neurotransmitter release • Fatigue supplements with a health well as mineral balance • Cell excitability • Hypertension care provider before taking in and out of body cells. • Hormone secretion • Hyperthyroidism any. Good food sources Potassium plays a role in • Heart rate • Muscle cramps include: avocado, banana, blood pressure regulation • Tone of vasculature and smooth • Postural hypotension mango corn, legumes, by limiting the effect of muscle • Stroke potatoes, tomatoes, sodium, muscle contraction, • Acid-base equilibrium • Kidney stones broccoli, spinach, leafy electrolyte balance, neuronal • Insulin sensitivity • Bone loss greens, carrots, pumpkin, transmission, and muscle raisins, cantaloupe, quinoa. contraction. Potassium is absorbed in the small intestine and excreted primarily in the urine, and body potassium levels are regulated in large part by the kidneys. Potassium is also excreted to some extent in the feces and sweat. Note: Increasing potassium intake may be dangerous in people with end stage renal disease and renal insufficiency, with certain endocrine disorders, and with certain medications. Individuals are encouraged to consult their health practitioners regarding potassium intake under these circumstances. Selenium Selenium is an essential • Antioxidation burns, depression, certain types seafood and organ meats. trace mineral found in soil, • Anti-inflammatory of cancer, cardiovascular disease, Brazil nuts, sunflower water, and some foods. • Immune function enhancement CHF, dementia/cognitive decline, seeds, brown rice, shiitake • Antiviral Down syndrome, hepatitis, male mushrooms, chia seeds, • Reproductive support infertility, lymphedema, myotonic lima beans, cabbage, • Thyroid hormone metabolism dystrophy, oral leukoplakia, spinach • DNA synthesi Osgood-Schlatter, and thyroiditis 18 Micronutrients Tested in the CMA Minerals

Mineral Description Important for May be useful for Good Food Sources prevention/treatment of

Strontium Strontium is a trace • Bone formation and quality osteoporosis, fractures, metastatic spices, seafood, mineral found in bone and • Prevention of bone resorption bone cancer, osteoarthritis, dental whole grains, root connective tissue. • Increase bone mineral density hypersensitivity, and dental caries. and leafy vegetables, • Anti-arthritis legumes, drinking • Dental support water, supplemental from- capsules, tablets. NOTE: Supplementation with strontium should be according to practitioner guidance. High dose strontium supplementation has adverse effects and is NOT recommended. Strontium supplementation is contraindicated in CVD, cerebrovascular disease, peripheral artery disease, renal disease, thromboembolic disorders. Vanadium Vanadium is a trace mineral. • Blood glucose transport and dental caries, impaired glucose mushrooms, shellfish, It is found in foods as well as metabolism tolerance, diabetes black pepper, parsley, in all body tissues. Highest • Bone growth dill seed, buckwheat, concentrations are found in • Lipid support grains, safflower oil, the liver, kidney, and bone. • Dental support beer, wine, drinking water, supplemental from- capsules, tablets. NOTE: Prolonged high dose supplementation may cause kidney damage. Vanadium supplementation is contraindicated in renal disease. Supplement only with practitioner guidance. Zinc Zinc is an essential mineral • Immune function and wound acne, brittle nails, warts, hearing, oysters, meat, poultry, involved in numerous healing olfactory and taste disorders, seafood, legumes, nuts, aspects of cellular • Protein and DNA synthesis colds, gastroenteritis, age-related seeds, peanuts, egg yolks, metabolism. It is a major • Growth and development macular degeneration, anorexia whole grains, wheat bran, component of over 300 • Proper sense of taste and smell, nervosa, ADHD, depression, RA, wheat germ, fruit, and metabolic enzymes. visual function, hearing psoriatic arthritis, BPH, body odor, dairy products. • Antioxidation and anti- cirrhosis, cancer, and more. inflammation • Protection of cell membranes • Production of stomach acid

19 Micronutrients Tested in the CMA Nutrients

Nutrient Description Important for May be useful for Good Food prevention/treatment of Sources

Alpha- AKG (alpha-ketoglutarate) is • Growth and development improving amino acid supplementation ketoglutarate a crucial intermediate of the • Bone formation metabolism in dialysis, Krebs cycle and is necessary for • Wound healing exercise tolerance, inhibition multiple metabolic processes in • Healing of muscle tissue of cellular pathways involved the body. • Fuel for cells of GI tract in the aging process, obesity, • Energy for cell processes, bacterial overgrowth, intestinal regulates amino acid disorders, lung function, mental concentration, enhances fatigue.. protein synthesis, control of lipid levels • Immune support • Antioxidation (as precursor to glutamate and glutamine Carnitine L-carnitine is a derivative of the • Mitochondrial function and certain cardiovascular issues animal foods such as amino acids, methionine and energy production and common diagnoses such meat, fish, poultry, lysine, and is synthesized in the • Immune, brain, liver, and as asthma, celiac disease, and dairy products liver, kidneys, and brain. It plays cardiac function cirrhosis, IBD, diabetes, erectile (mostly in whey). a key role in energy production • Elimination of toxic compounds dysfunction, NAFLD, fatigue, and is found in almost every cell • Blood lipid levels- reduction of PCOS, COPD, and more. of the body. Only L-carnitine is triglycerides, increase in HDL biologically active and is the form found in food. It is concentrated in skeletal and cardiac muscle tissues. Choline Choline is an essential nutrient • Early brain development hypercholesterolemia, meat, poultry, fish, needed for many steps in • Cell membrane structural depression, memory loss, dairy products, and metabolism. It is not classified integrity and signaling cognitive decline, and liver eggs. Cruciferous as a vitamin or a mineral. It is • Production of neurotransmitter, disease. vegetables, kidney often grouped with the vitamin acetylcholine beans, soybeans, B complex due to its similar • Memory, mood, and muscle nuts, seeds, and properties and functions. control whole grains. • Gene expression • Lipid transport and metabolism • Brain and nervous system functions Glutathione Glutathione is produced in • DNA synthesis and repair cancer, Parkinson’s disease, Fruit, vegetables, and the liver from the amino acids, • Metabolism of toxins and neurodegenerative disorders, meat but glutathione glycine, cysteine, and glutamic carcinogens flu, AMD, glaucoma, cataracts, is poorly absorbed acid. It is considered the body’s • Immune support diabetes, heart disease, asthma from the GI tract. “master antioxidant”. • Prevention of oxidative cell (not inhaled glutathione), Consuming foods damage lung disease, liver disease, GI used in cysteine • Protein and prostaglandin disease, CFS, and side effects of production is synthesis chemotherapy recommended- • Transport of amino acids onions, garlic, chives, • Antioxidation,-fights free leeks. Supplementing radicals with N-acetyl • Antiviral L Cysteine can • Anti-inflammation boost glutathione levels. Glutathione can be taken IV or in liposomal supplemental form.

20 Micronutrients Tested in the CMA Nutrients

Nutrient Description Important for May be useful for Good Food prevention/treatment of Sources

Inositol Inositol is structurally similar to • Cell membrane components, Alzheimer’s disease, whole grains, glucose. It was once considered cell signaling bronchopulmonary dysplasia buckwheat, peanuts, to be part of the B vitamin • Lipoprotein components (BPD), depression, diabetes legumes, nuts, seeds, complex but now known to • Proper function of hormones (d-chiro inositol)/gestational grapefruit, other be produced in the human • Possibly enhancing insulin diabetes, NAFLD, OCD, panic citrus fruits, and body so is now referred to as sensitivity attacks, and PCOS cantaloupe a pseudovitamin. Inositol is present in two forms, myo-inositol and D-chiro-inositol.

21 Cellular Micronutrient Assay (CMA)

What does it mean to be deficient in a nutrient?

Many factors impact nutritional status: food and beverage intake, digestion, absorption, age, disease states, stress, medications, exposure to toxins, genetics, and activity level.

A nutritional deficiencyis defined as an inadequacy of nutrients in cells or tissues, resulting from inadequate dietary intake or altered digestion, absorption, or metabolism. Nutrient deficiency diseases described in the early 1900s represent the end stage result of prolonged nutrient insufficiency. However, more recent discoveries reveal that years of subclinical nutrient insufficiency (without classic symptoms of deficiency) can cause a less recognizable progression of chronic disease. Insufficiency at the cellular level can be seen without the individual expressing symptoms of overt deficiency or disease. If the need for particular nutrients is not addressed, the insufficiency may progress to early stage disease.

Nutrient insufficiencies and deficiencies can lead to chronic disease, a well-established fact. Such consequences can be mitigated or prevented using targeted nutrition support with an individualized food and supplement routine. We have an abundant food supply, how could we not meet nutrient needs? The Standard American Diet, which consists of highly processed foods, is inherently calorie rich yet nutrient deficient. Many individuals are NOT consuming the daily recommended amount of fruits and vegetables and insufficient micronutrient intake has been well documented. Intake of several nutrients falls below 50% of recommended levels in the United States. The National Health and Nutrition Examination Surveys (NHANES) consistently reveal that the U.S. population does not meet recommended intake levels for several nutrients including magnesium, calcium, zinc, vitamins A, B6, C, and D. • Nutrients can become depleted due to growing conditions, harvest timing and methods, prolonged transportation, storage, processing, and cooking. Modern farming techniques have resulted in a decrease in the nutrient content of many foods. Decreased nutrient levels in crops are thought to result from a shift to plants that produce higher yields at the expense of lower nutrient content. Nutrient-depleted soil yields nutrient-depleted crops. • Nutrient malabsorption is often seen in people with gastrointestinal diseases, small intestinal bacterial overgrowth, hypochlorhydria (low stomach acid), and pancreatic enzyme deficiency.

22 Cellular Micronutrient Assay (CMA) • Inherited enzyme defects may produce insufficient availability of certain essential nutrients. Impaired conversion of a vitamin to its active coenzyme form can also lead to an increased requirement for the vitamin. • Many nutrients, particularly vitamins, must be in their active form in order to carry out metabolic functions. Some individuals may require the active form of a nutrient due to genetic variations such as single nucleotide polymorphisms (SNPs). Most commercial brands of dietary supplements do not incorporate the bioactive form of nutrients and therefore may not be utilized optimally. • Certain medications can promote nutritional depletion and deficiencies. • Chronic illness can result in nutritional deficiencies. Patients with compromised gastrointestinal function, inflammation, and/or dysbiosis often have elevated nutrient requirements that may not be met from what is consumed. Individuals may fail to meet their nutrient needs despite adequate intake if they are unable to sufficiently absorb, transport, process, or utilize nutrients due to GI dysfunction.

Should I take supplements? It is always best to focus on food first! Supplementing a poor eating pattern will not undo the detrimental effects of the constant consumption of an eating pattern based on highly processed foods devoid of the nutrients found in whole, unpackaged, unprocessed foods. If the eating pattern is much like the SAD (Standard American Diet), it is necessary to work to change that. Supplements alone will not replace the benefits of a plant-based eating pattern.

However, supplements can help fill in nutrient gaps and replete nutrients that show up as insufficient in the CMA. There is no “one size fits all” approach to nutrition and the same is true for nutrition supplementation. Nutrient form, recommended dosage, and length of supplementation period should all be taken into consideration. Individuals should seek the assistance of a qualified nutrition practitioner for a personalized nutrition and supplementation routine. Dosing recommendations for nutrients can vary depending on current nutritional status, medical conditions, genetic traits, exposure to toxins, increased need for detoxification, age, gender, increased metabolic demands, pregnancy, lactation, etc. A qualified practitioner must take into account all pertinent factors of an individual’s history and CMA/APA results within the context of a thorough nutrition assessment before determining individual nutrient needs and appropriate interventions.

It is important to choose appropriate products that are optimally formulated, safe, pure, accurately labeled, and that adhere to CGMPs. Check on a manufacturer’s third-party certification or call the company to obtain verification that they are following CGMPs. Individual requirements, tolerances, sensitivities, preferences, and even genetic makeup must all become part of an effective supplement plan. 23 Understanding Your Redox Assay Results

Oxidative stress is a significant contributor to chronic disease. “Redox’ (reduction-oxidation) is a chemical reaction involving the increase and decrease in oxidation that occurs during metabolic reactions. A prolonged imbalance of oxidants and antioxidants, and its association with physiological damage and chronic disease, has prompted the need for measuring redox imbalances and antioxidant capacity within cells. The Redox Assay is a measurement of the cells’ resistance to oxidative stress and its overall antioxidant capacity.

How the Redox Assay Works A free radical generating system (H2O2) is added to the lymphocytes. Depending on the functional antioxidant capacity of the tested cells, peroxide may diminish cells’ growth rates and/or damage cells to the point of cell death (apoptosis or necrosis). The cells’ ability to resist oxidative damage and prevent further damage to cells is determined and compared to that of the general population.

Test Report The color coded report reflects the results of antioxidant function.

Red range= the Redox Score indicates a below average response. Light blue range= the Redox Score indicates an average response. Blue range = the Redox Score indicates an above average response.

Improvement of antioxidant function may be achieved by appropriate use of nutrients and antioxidants as determined by the Antioxidant Protection Assay as well as guidance from the healthcare practitioner.

24 Understanding Your Antioxidant/Anti-Inflammatory Protection Assay Results

Oxidation, a chemical reaction caused by free radicals, can be very damaging to cells, tissues, and organs.

Oxidative stress occurs when there is an imbalance between the formation and the removal of free radicals due to their overproduction and/or an impaired ability to neutralize them or repair the damage they create. When the body is unable to neutralize free radicals, cell membranes, tissues, and circulating lipids will undergo oxidative damage.

The body is under constant attack from oxidative stress. Substances that create free radicals can be found in the food and water we consume, the air we breathe, and the medicines we take. Consuming fried foods and industrial vegetable oils; smoking; alcohol consumption; chronic psychological stress; poor sleep; sedentary lifestyle; and exposure to environmental toxins, pesticides, heavy metals, radiation, and air pollution, have been associated with free radical and oxidative damage.

Oxidative damage is recognized as an underlying factor in many chronic diseases including autoimmune disease, cardiovascular disease, type 2 diabetes, chronic kidney disease, neurodegenerative diseases, and cancer.

An antioxidant is a substance that prevents oxidation and protects cells from damage caused by the impact of free radicals. The body produces some antioxidant enzyme systems on its own to scavenge free radicals, but in insufficient quantities. Obtaining antioxidants from a whole-foods eating pattern that emphasizes plenty of colorful fruits and vegetables is the best way to boost antioxidant levels in the body. Supplementing with antioxidants (with practitioner guidance) may also be helpful but it is important to start with food first. Other nutrients in plants called phytonutrients may work “in concert” with the antioxidant compounds to provide benefit. This benefit may not be obtained from simply taking supplements.

An imbalance in available antioxidants contributes to chronic inflammation, an underlying factor in a number of disorders including arthritis, diabetes, cardiovascular disease, gastrointestinal dysfunction, and cancer. Many nutrients play both an antioxidant and an anti-inflammatory role in protecting cells and tissues from damage and destruction. Monitoring sufficiency of these nutrients is an important step in managing and preventing chronic disease.

25 Antioxidant Protection Assay (APA)

The Antioxidant Protection Assay (APA) determines which specific antioxidant nutrients may be beneficial and support the patient’s cells to resist oxidative stress.

How it works Single antioxidants are added to the patient’s cells and serum in the presence of oxidative stress molecules. This process is repeated for each individual antioxidant. Specific antioxidants that support recovery of patients’ lymphocytes from the effect of the oxidative stress are reported as highly protective or protective.

Test Report

“Highly Protective” indicates a proliferation rate of greater than 120% of patient’s baseline = significant protection from cell damage.

“Protective” indicates a proliferation rate of 110-120% of the patient’s baseline = protection from cell damage.

“No Significant Response” indicates up to 109% of the patient’s proliferation rate = no significant protection from cell damage.

26 Antioxidant/Anti-Inflammatory Nutrients Tested in the APA

The pages that follow include descriptions of the antioxidant nutrients, enzymes, botanicals, pigments, and phytonutrients as well as the anti-inflammatory fatty acids that are tested in the Antioxidant Protection Assay.

The descriptions that follow are for educational purposes only. Statements are not to be interpreted as treatment recommendations and do not take the place of advice from a qualified practitioner. Please be aware that botanicals and high doses of certain nutrients may interact with medications, botanicals, and medical diagnoses, and therefore may be contraindicated. The patient is encouraged to seek guidance and an individualized food and supplement plan from a qualified nutrition practitioner.

Antioxidant Description Important for/ May be useful in Sources Potential Beneficial the treatment or Properties prevention of Beta-Carotene Beta-Carotene is a pigmented, • Anti-inflammatory cognitive decline, dementia, green leafy vegetables-spinach, fat-soluble compound called a • Antioxidant AMD, breast cancer, kale, collard greens, orange-yellow carotenoid. It is converted in • Tumor cell growth GERD, sunburn, retinitis fruits and vegetables- sweet potato, part to vitamin A in the body. It inhibition pigmentosa, erythropoietic carrots, pumpkin, squash, cantaloupe, is converted to retinal which • Cardiovascular protoporphyria, rash from bell peppers, broccoli, asparagus is essential for vision. Then protection sun exposure, and signs of converted to retinoic acid, • Immune enhancing aging it is used in growth and cell differentiation. Catalase Catalase is a key antioxidant • Antioxidation degenerative disease, wheat and barley grass, alfalfa, enzyme in the body’s defense • Anti-aging and anti- mitochondrial dysfunction, Brussels sprouts, leeks, onions, against oxidative stress. It degenerative cardiac issues, and broccoli, parsnips, zucchini, spinach, converts free radicals into • Longevity support cataracts kale, radishes, carrots, red peppers, hydrogen peroxide which • Fat metabolism turnips, cucumbers, celery, avocado, ultimately breaks down to stable • Support of DNA integrity potato, and red cabbage, kiwi, and safe water and oxygen. peaches, cherries, apricots, bananas, watermelon, pineapple Coenzyme Q10 Coenzyme Q10 is a fat-soluble • Antioxidation mitochondrial dysfunction, As supplements, there are two compound that is synthesized in • Analgesic Alzheimer’s disease, forms of CoQ10 that are available, the body with the highest levels • Membrane stabilization AMD, eye disorders, the oxidized form (ubiquinone) and in the heart, liver, kidneys, and • Anti-aging cardiovascular disease, the reduced form (ubiquinol) . Food pancreas. It is present in small • Anti-inflammatory CHF, cardiomyopathy, sources include meat, poultry, fish, amounts in some foods. It’s • Cofactor in energy myocardial infarction, soy, nuts, fruit, vegetables, eggs, and chemical structure is similar to synthesis hyperthyroidism, infertility, dairy. vitamin K. • Immune support neuropathy, fibromyalgia, hypertension, migraines, NAFLD, Parkinson’s disease, Huntington’s disease, pre-eclampsia, PCOS, and respiratory illness Delta gamma Delta tocotrienol is a natural form • Antioxidation hyperlipidemia, palm oil, rice bran , annatto seeds. tocotrienol of vitamin E. Vitamin E is a group • Antiaging certain types of The most potent source, annatto of eight fat soluble compounds that • Anti-inflammatory cancer, atherosclerotic beans/pods are not edible but include four tocopherols (alpha, • Anticancer heart disease, supplemental sources often derive beta, gamma and delta) and four • Brain health metabolic syndrome. tocotrienols from the annatto tocotrienols (alpha, beta, gamma, • Bone health NAFLD, Parkinson’s bean. Supplementation is normally and delta). Studies suggest that • Cardiovascular effects disease,osteopenia/ necessary. tocotrienols can provide health • Prevention of platelet osteoporosis benefits distinct from alpha- tocopherol, the most well known aggregation form of vitamin E. Tocotrienols • Hypolipidemic effects have greater fluidity which makes it • Neuroprotective effects easier for the body to incorporate them into cell membranes, especially delta-tocotrienol.

27 Antioxidant/Anti-Inflammatory Nutrients Tested in the APA

Antioxidant Description Important for/ May be useful in Sources Potential Beneficial the treatment or Properties prevention of Glutathione Glutathione is produced in the • DNA synthesis and cancer, Parkinson’s disease, Fruit, vegetables, and meat but liver from the amino acids, glycine, repair neurodegenerative glutathione is poorly absorbed cysteine, and glutamic acid. It is • Metabolism of toxins disorders, flu, AMD, from the GI tract. Consuming foods considered the body’s “master and carcinogens glaucoma, cataracts, used in cysteine production is antioxidant”. • Immune support diabetes, heart disease, recommended- onions, garlic, chives, • Prevention of oxidative asthma (not inhaled leeks. Supplementing with N-acetyl L cell damage glutathione), lung disease, Cysteine can boost glutathione levels. • Protein and liver disease, GI disease, Glutathione can be taken IV or in prostaglandin synthesis CFS, and side effects of liposomal supplemental form. • Transport of amino chemotherapy acids • Antioxidation,-fights free radicals • Antiviral • Anti-inflammation Lipoic Acid Lipoic acid is synthesized by • Antioxidation aging skin associated with red meat, organ meats, spinach, humans and is present in a wide • Anti-inflammatory sun damage, cognitive broccoli, potatoes, yams, carrots, range of foods. • Regeneration of other decline, diabetes, insulin beets, and yeast antioxidants- vitamin resistance, erectile E, vitamin C, and dysfunction, glaucoma, glutathione NASH, peripheral • Endocrine support, neuropathy, burning glucose regulation mouth syndrome, obesity, • Anti-obesity hepatitis, migraines, • Antiviral myopathy, taste disorders, • Cardiovascular support vitiligo, and wound healing • Vascular support • Neurological support • Bone support Lutein Lutein is a carotenoid vitamin, • Antioxidation AMD, cataracts, cognitive kale, spinach, broccoli, corn, kiwi, lutein is related to beta-carotene • Light filter decline, certain types of grapes, orange juice, squash, egg and is one of two major • Ocular protection cancer, CVD, and diabetes yolk, pistachios carotenoids (and zeaxanthin) found as a color pigment in the human eye. NADH NADH is the reduced form of • Energy generation CVD, Parkinson’s disease, Supplemental from- capsules, tablets. nicotinamide adenine dinucleotide • Antioxidation Chronic Fatigue Syndrome (NAD), a coenzyme involved in • Cardiovascular support a variety of reactions within the • Lipid lowering body. NADH is synthesized in • Antihypertensive the body from vitamin B3 and is • Dopaminergic involved in mitochondrial energy production. Pyrroloquinoline PQQ is a micronutrient that • Antioxidation pain, inflammation, sleep tofu, natto, miso, spinach, fava bean, resembles the B vitamin family. It • Mitochondrial difficulties, cognitive issues, carrots, papaya, kiwi, green peppers, acts as an antioxidant, protecting protection and dementia, Parkinson’s parsley, green tea, potato, sweet cells (specifically mitochondria) formation disease, fatigue, and potato, cabbage, banana, tomato, egg from damaging free radicals. • Neuroprotectant elevated LDL cholesterol yolk, orange, celery • Growth and development • Cardiovascular support • Cognitive support (learning and memory) • Anti-inflammatory • Energy production 28 Antioxidant/Anti-Inflammatory Nutrients Tested in the APA

Antioxidant Description Important for/ May be useful in Sources Potential Beneficial the treatment or Properties prevention of Selenium Selenium is an essential trace • Antioxidation burns, depression, seafood and organ meats. Brazil nuts, mineral found in soil, water, and • Anti-inflammatory certain types of cancer, sunflower seeds, brown rice, shiitake some foods. • Immune function cardiovascular disease, mushrooms, chia seeds, lima beans, enhancement CHF, dementia/cognitive cabbage, spinach • Antiviral decline, Down syndrome, • Reproductive support hepatitis, male infertility, • Thyroid hormone lymphedema, myotonic metabolism dystrophy, oral leukoplakia, • DNA synthesis Osgood-Schlatter, and thyroiditis Superoxide Superoxide Dismutase (SOD) is an • Antioxidation bronchopulmonary yeast, spinach, chicken liver, broccoli, Dismutase (SOD) essential enzyme found in all living • Anti-inflammatory dysplasia, interstitial cystitis, Brussels sprouts cells. SOD catalyzes the conversion gout, osteoarthritis, RA, of superoxide to oxygen and familial ALS, Parkinson’s hydrogen peroxide, reducing disease, Alzheimer’s damage from ROS, harmful oxygen disease, heart damage after molecules. MI, dengue fever, cancer, Down’s syndrome, sports injuries, cataracts, radiation therapy, neurological disorders, and corneal ulcers Vitamin C Vitamin C (ascorbic acid) is a water • Antioxidation allergic rhinitis, citrus fruits, raspberries, strawberries soluble vitamin that is essential for • Anti-inflammation cardiovascular issues, pineapple, kiwi, cantaloupe, greens, human survival. • Immune function sinusitis, GI issues- cruciferous vegetables- Brussels • Blood vessel formation constipation, gallstones, sprouts, broccoli, squash, green • Muscle formation gastritis, cold and flu, beans, carrots, potatoes, tomatoes, • Collagen production UTIs, muscle cramps, peppers • Brain health/ dysfunctional uterine neurotransmitter bleeding, glaucoma, production depression, asthma, certain • Absorption of iron types of cancer, diabetes, • Blood lipid regulation obesity, and post exercise • Detoxification muscle soreness (Eicosapentaenoic Eicosapentaenoic acid (EPA), • Cell membrane stability atherosclerosis/ The body can convert some ALA acid) EPA one of the three main omega-3 and fluidity ischemic heart disease, (alpha-linolenic acid) to EPA but in fatty acids, is a long-chain • Anti-inflammatory – cardiac arrhythmias, only very small quantities. Therefore, polyunsaturated fatty acid that proper function of the CHF, hypertension, getting EPA from foods or dietary is found in the tissues of oily fish body’s inflammatory hypertriglyceridemia, supplements is the only practical way and marine mammals. EPA is system depends raynaud’s disease, eczema, to increase levels of EPA in the body. often used in conjunction with on prostaglandins psoriasis, IBD-Crohn’s Most fish (cod, haddock, mackerel, docosahexaenoic acid (DHA) for (messaging disease, ulcerative colitis, sardines, ocean trout, whiting, tuna, a variety of conditions. Omega molecules). Many of migraines, multiple salmon, halibut, flounder, grouper, 3 fatty acids are important the prostaglandins sclerosis, anxiety, ADHD, red snapper, sole, rainbow trout) and components of cell membranes. are made from EPA bipolar disorder, cognitive sea plants are good sources. The All of these fatty acids contain and tend to be anti- function, depression, omega-3 fatty acid content of farmed “double bonds”- connections that inflammatory. rheumatoid arthritis, fish is generally lower than that of make them flexible and interactive • Antiplatelet asthma, BPH, cancer, wild fish. Other grass fed animal but also more susceptible to • Decrease in blood NAFLD, periodontal sources that supply some EPA-eggs, damage. EPA has five double viscosity disease, PCOS, and more. dairy, meats . bonds. • Cardiovascular effects • Immunomodulatory • Reduction in serum triglycerides • Neurological effects

29 Antioxidant/Anti-Inflammatory Nutrients Tested in the APA

Antioxidant Description Important for/ May be useful in Sources Potential Beneficial the treatment or Properties prevention of Docosahexaenoic Docosahexaenoic acid (DHA) • Cell membrane stability atherosclerosis/ The body can convert some ALA acid (DHA) one of the three main omega-3 and fluidity ischemic heart disease, (alpha-linolenic acid) to DHA but in fatty acids, is a long-chain • Anticancer cardiac arrhythmias, only very small quantities. Therefore, polyunsaturated fatty acid that • Anti-inflammatory CHF, hypertension, getting DHA from foods or dietary is found in the tissues of oily fish • Brain/CNS development hypertriglyceridemia, supplements is the only practical way and marine mammals. DHA is and function- DHA raynaud’s disease, eczema, to increase levels of DHA in the body. often used in conjunction with accounts for 9-12% of psoriasis, IBD-Crohn’s Most fish (cod, haddock, mackerel, eicosapentaenoic acid (EPA) for the brain’s total weight. disease, ulcerative colitis, sardines, ocean trout, whiting, tuna, a variety of conditions. Omega • Cardiovascular effects migraines, multiple salmon, halibut, flounder, grouper, 3 fatty acids are important • Decrease in blood sclerosis, anxiety, ADHD, red snapper, sole, rainbow trout) and components of cell membranes. viscosity slower neurological sea plants are good sources. The All of these fatty acids contain • Immunomodulatory development in children. omega-3 fatty acid content of farmed “double bonds”- connections that • Neurologic effects bipolar disorder, cognitive fish is generally lower than that of make them flexible and interactive • Protection of retinal function, depression, wild fish. Other grass fed animal but also more susceptible to function rheumatoid arthritis, sources that supply some DHA-eggs, damage. DHA has six double asthma, BPH, cancer, dairy, meats . bonds. Proper function of the NAFLD, periodontal nervous system, including the disease, PCOS, retinitis brain, depends on the presence pigmentosa, visual acuity, of DHA. and more. Linoleic Acid Linoleic Acid, an omega-6 fatty • Cardiovascular effects atherosclerosis/ safflower oil, sunflower oil, wheat (omega-6) acid, is considered an essential • Dermatologic effects ischemic heart disease, germ oil, hempseed oil, corn oil, fatty acid because humans are • Maintenance of hypercholesterolemia, soybean oil, peanut oil and canola oil not able to synthesize it. All of the epidermal water barrier hypertension, eczema, other biologically active omega-6 of the skin pruritius, scleroderma, fatty acids can be made from • Cell membrane fluidity, dyslexia, essential tremor, linoleic acid. Omega 6 fatty acids structure, and function multiple sclerosis, alcohol are considered by some to be • Anti-inflammatory, pro- hangover, BPH, obesity, pro-inflammatory. The relationship inflammatory periodontitis, rheumatoid between omega-6 fatty acids arthritis, atopic dermatitis. and inflammation is complex as some may be metabolized to pro-inflammatory arachidonic acid but also to prostaglandin E1 which is has anti-inflammatory activity. Consumption of large amounts of linoleic acid and other polyunsaturated fatty acids increases oxidative stress. Excessive consumption of omega 6 fatty acids is best avoided. Palmitoleic acid Palmitoleic acid is a non-essential, • Anti-inflammatory stroke, diabetes, metabolic macadamia oil, macadamia nuts, (omega-7) monounsaturated fatty acid that is • Anti-thrombotic effects syndrome, cardiovascular buckthorn seed oil, marine sources a common constituent of human • Insulin sensitivity health, LDL reduction, adipose tissue. It is found in all • Lipid metabolism increase of HDL. tissues with highest concentration • Hemostasis in the liver.

30 Antioxidant/Anti-Inflammatory Nutrients Tested in the APA

Antioxidant Description Important for/ May be useful in Sources Potential Beneficial the treatment or Properties prevention of Oleic Acid Oleic acid is an omega 9 fatty acid • Anti-inflammatory Age related cognitive Plant oils such as olive oil, almonds/ (omega-9) that is considered non-essential • Cardiovascular effects decline, type 2 diabetes, almond oil, hazelnuts, avocado oil, since it can be manufactured in • Brain function cardiovascular disease, pecans, macadamia nuts, apricot the body but research indicates • Cholesterol, lipid, and hyperlipidemia, kernel oil, cashews, cheese, beef, that increasing consumption blood pressure lowering hypertension, Alzheimer’s eggs, sesame oil, sunflower oil, argan of omega 9 fatty acids may be • Dermatological effects- disease, ulcerative colitis, oil, grapeseed oil. beneficial. It is an unsaturated skin repair infections, skin conditions. fatty acid that is the most widely • Immune support distributed and abundant fatty • Fat metabolism acid in nature, occurring naturally • Insulin sensitivity in the fats and oils of both animals • Cell membrane and vegetables. structure Zinc Zinc is an essential trace mineral • Immune function and acne, brittle nails, warts, Oysters, meat, poultry, seafood, involved in numerous aspects of wound healing hearing, olfactory and taste legumes, nuts, seeds, peanuts, egg cellular metabolism. It is a major • Protein and DNA disorders, colds,influenza, yolks, whole grains, wheat bran, component of over 300 metabolic synthesis certain viruses, upper wheat germ, fruit, and dairy products enzymes • Reproduction respiratory infections, • Growth and gastroenteritis, age-related development macular degeneration, • Proper sense of taste anorexia nervosa, ADHD, and smell, visual depression, RA, psoriatic function, hearing arthritis, BPH, urinary tract • Antioxidation and anti- infections, body odor, inflammation cirrhosis, cancer, Wilson’s • Protection of cell disease. membranes • Hormone function • Production of stomach acid

IMPORTANT: Identified adverse food reactions- allergies, sensitivities, and intolerances- should be avoided even if these cellular tests have shown those food sources of micronutrients/botanicals to be “beneficial”. The CMA and APA test the responses of B and T lymphocytes, not antibodies (IgE- mediated allergies) or cells of the innate immune system (Alcat Test). Patients and practitioners are encouraged to carefully read all product/supplement labels and avoid all ingredients that are contraindicated for any reason.

31 Botanicals & Phytonutrients Tested in the APA

Botanical/ Description Potential Beneficial May be useful for Sources Phytonutrient Properties prevention/treatment of Acai Berry Acai berry is a palm tree • Anti-inflammatory hypercholesterolemia, fruit can be widely distributed in the • Antibacterial metabolic syndrome/weight consumbed raw northern area of South • Antioxidant loss and obesity, diabetes, or as a juice. As America, particularly the • Anticancer detoxification, aging skin, supplement can be Brazilian Amazon region. The • Blood glucose support and for improving general found in powders, fruit of acai is round, dark • Cardiovascular support health tablets, and purple in color, and edible • Immune support capsules

Andrographis Andrographis is a plant that • Analgesic common cold, influenza, supplementation is native to South Asian • Antibacterial tonsillitis, IBD- ulcerative countries such as India and • Anti-viral colitis, and RA Sri Lanka. Known as the “King • Anti-inflammator of bitters”, it is commonly • Antiplatelet used in Ayurvedic medicine. • Anticancer • GI, cardiovascular, liver support • Blood glucose regulation • Immunomodulatory

Astaxanthin Astaxanthin is a naturally • Antioxidation Alzheimer’s disease, Salmon, trout, occurring carotenoid • Anti-asthmatic dementia, Parkinson’s shrimp, lobster pigment found in nature • Anti-cancer disease, CVD, obesity, primarily in salmon, trout, • Anti-inflammation certain types of cancer, shrimp, and lobster. It is • Cardiovascular protection sunburn, fatty liver, similar to beta-carotene in • GI and liver protection reflux due to H. pylori, structure. It gives salmon, • Immune support hyperlipidemia, RA, and shrimp, and lobster their • Fat metabolism wrinkled skin pink-red color. Astragalus Extract Astragalus comes from the • Antibacterial common cold, upper The root of the root of a perennial plant • Anti-inflammatory respiratory infections, astragalus plant in the legume family that • Antioxidant fibromyalgia, diabetes, is put in soups, grows in the northern and • Antiviral blood pressure, heart teas, extracts, and eastern parts of China as well • Bone support disease, weakness, arthritis, capsules. as in Mongolia and Korea. • Cardiovascular support hepatitis, breast and lung There are more than 2,000 • Fertility –increase in sperm cancer, asthma, and anxiety species of astragalus but motility most astragalus supplements • Blood glucose support contain Astragalus • Liver and kidney protective membranaceus. Astragalus • Immune support contains a variety of active • Vasorelaxant constituents including more • Wound healing than 40 saponins, several flavonoids, polysaccharides, trace minerals, amino acids, and coumarins. – Astragalus is also called huang qi or milk vetch.

32 Botanicals & Phytonutrients Tested in the APA

Botanical/ Description Potential Beneficial May be useful for Sources Phytonutrient Properties prevention/treatment of Camu Camu Camu Camu is a berry that • Antioxidation Diabetes, diabetes The fruit itself is grows in the Amazonian • Anti-inflammation complications, extremely acidic rainforest. Is one of the best • Immune support inflammation, overweight/ and sour. In food sources of vitamin C. • Gut health obesity, hypertension. order to increase It contains phytonutrients, • Antimicrobial palatability, dilution minerals, serine, leucine and and sugar is added. valine as well as carotenoids. Supplemental form- powder, capsules, tablets is most often used. Chlorophyll Chlorophyll is a pigment that • Anti-aging acne, herpes simplex greens, chlorella, gives plants their green color. • Anti-cancer virus and shingles, lung spirulina, alfalfa, • Antiviral and other types of cancer, parsley, broccoli, • Deodorant pancreatitis, skin cancer, green cabbage, • Wound healing fatigue, arthritis, and asparagus, green fibromyalgia beans and peas, matcha green tea, wheat grass, algae and supplemental form. Echinacea Echinacea is a perennial • Antibacterial infections, common cold, Echinacea is often wildflower native to North • Antifungal herpes simplex infection sold as an herbal America and is closely related • Anti-inflammatory (topical), psoriasis(topical), supplement. to sunflowers, daisies, and • Anti-oxidant gum inflammation, upper ragweed. • Anti-vital respiratory tract infections • Immune stimulating (viral), tonsillitis, urinary • Wound healing tract infections, vaginal yeast infection, skin wounds/ulcers (topical), and leukopenia from chemotherapy. Elderberry Elderberry is the dark • Antioxidant shorten duration of Cooked purple berry of the • Immunological support common cold, influenza, elderberries European or Black elder, • Anti-inflammatory and constipation are used as found in warmer areas of a flavoring in North America, Europe, foods and wine. Asia, and Northern Elderberries are Africa. A rich source of also in foods flavonoids, quercetin, like jams and rutin, phytosterols, pies. Available carotenoids, and vitamins in supplemental and minerals, the form as well berries are cultivated for medicinal and food purposes. Frankincense Frankincense is the • Anti-inflammatory pain and inflammation, topically, hardened gum resin • Anti-bacterial asthma, acne, signs aromatherapy extruded from the trunk • Antiviral of aging, Crohn’s of the Boswellia carteri • Anti-anxiety disease, IBS, diabetes, tree. • Antiseptic, disinfectant cancer, osteoarthritis, • Immune enhancing depression, anxiety, • Memory enhancing leaky gut, gas, and • Hormone balancing constipation • Digestive aid 33 Botanicals & Phytonutrients Tested in the APA

Botanical/ Description Potential Beneficial May be useful for Sources Phytonutrient Properties prevention/treatment of Gingko Biloba Gingko biloba is a large • Anticancer anxiety, Alzheimer’s tea and extracts tree with fan-shaped leaves • Anticoagulant/antiplatelet disease, mixed dementias, supplementation via with radiating veins . It is • Blood glucose support PMS, schizophrenia, tablets and capsules one of the oldest living • Anti-inflammation tardive dyskinesia, vertigo, tree species in the world. • Antimicrobial AMD, altitude sickness, Native to temperate Asia, • Antioxidant metastatic colorectal including China, Japan, and • Cardiovascular support cancer, depression, diabetic Korea, but is now cultivated • Lipid lowering retinopathy, dyslexia, in Europe and the United • Neurological support fibromyalgia, gastric cancer, States. It is the last remaining glaucoma, hemorrhoids, species of a primitive family ovarian cancer, PAD, of gymnosperms called Raynaud’s syndrome, Ginkgoaceae. vitiligo” Goji Berry Goji berry, also known as • Anticancer • Diabetes goji berries can be wolfberry, is a nutrient rich • Blood glucose support • Dry eye eaten raw, cooked, bright orange-red berry that • Antifatigue • Athletic performance or dried. Often comes from a shrub native • Antimicrobial • Sleep quality found in herbal teas to China and distributed in • Antioxidant • Fatigue and wines. Asia, the Mediterranean, • Cardiovascular support • Mood support North America, and Australia. • Hepatoprotective • Overweight The root bark and sweet, • Immune support • Glaucoma red fruits of goji are used in • Fertility traditional Chinese medicine. • Hyperlipidemia Grape Seed Grape Seed extract is derived • Antioxidation signs of aging, fibromyalgia, grapes, oil, from the ground up seeds • Circulation support certain types of cancer, supplemental form of red wine grapes. is used • Lipid lowering hyperlipidemia, chronic as a dietary supplement. • Anti-allergic, immune support venous insufficiency, It contains antioxidant • Anti-arthritic diabetes-related eye compounds, oligomeric • Antibacterial disease, ocular stress, proanthocyanidin. • Anticancer wound healing, NAFLD, and • Antifungal PMS • Anti-inflammatory • GI support, laxative, expectorant • Antiviral • Bone support • Wound healing Green Tea Extract Green tea is derived from • Immune support elevated blood pressure, tea, supplemental the plant, Camellia sinensis. • Anti-inflammatory high cholesterol, heart form, capsules Green tea extract is simply • Antioxidant disease, Insulin resistance, green tea leaves prepared as • Anticoagulant/antiplatelet obesity, Alzheimer’s a supplement. Green tea and • Blood glucose regulation disease, Parkinson’s its extracts, such as ECGC • Antilipemic disease, cancer, (Epigallocatechin gallate), • Antiviral inattentiveness, genital a polyphenol, have been • Bone support warts, and inflammation studied for their antioxidant • Regulation of blood pressure effects and possible • Protective against certain protective impact against types of cancer heart disease and cancer. • Stimulation of CNS • Improved cognitive performance • Reduction in dental plaque • Diuretic • Enhancement of muscular endurance in exercise • Increase in calorie and fat metabolism 34 Botanicals & Phytonutrients Tested in the APA

Botanical/ Description Potential Beneficial May be useful for Sources Phytonutrient Properties prevention/treatment of Lavender Lavender is a perennial • Analgesic anxiety, depression, stress, capsules, via evergreen plant that is • Antibacterial psychological well-being, aromatherapy, and native to countries in the • Anticancer dysmenorrhea, pain, topically Mediterranean region. The • Lipid reduction intestinal problems, and applicable parts of lavender • Antifungal high cholesterol are the flowers, leaves, and • Anti-inflammatory oil. • Hair growth • Neurologic/CNS effects- relaxation, sedation • Wound healing Lycopene Lycopene is a reddish • Antioxidant asthma, prostate tomato products, carotenoid found in some • Antiplatelet cancer, atherosclerosis, watermelon, pink fruits and vegetables. • Lipid lowering hypertension, CHF, anti- grapefruit, papaya, • Free radical scavenger platelet, hyperlipidemia, guava, and apricots sunburn, oral leukoplakia, and infertility Maitake Mushroom This edible and medicinal • Tumor inhibition diabetes, PCOS, Maitake is available mushroom, is a perennial • Immune system support certain types of cancer, fresh and in fungus that grows in clusters • Anti-inflammatory hypertension, and hepatitis powders, capsules, at the base of trees. The • Antiviral B and extracts active constituents of • Blood glucose regulation maitake include beta- • Cardiovascular support glucans, agarico glycerides, • Hormonal support and fiber. • Blood lipid reduction Mangosteen Mangosteen is a tropical fruit "• Antioxidation diarrhea, UTIs, gonorrhea, mangosteen fruit, cultivated in Southeast Asia. • Anti-allergy thrush, tuberculosis, supplemental form The fruit, fruit juice, rind, • Antibacterial cardiovascular issues, twig, and bark are used as • Anti-inflammatory menstrual disorders, medicine. • Antiviral cancer, osteoarthritis, • Immune support dysentery, and skin issues • Astringent • Free radical scavenger Milk Thistle Milk thistle, also known • Antioxidant Liver disorders, skin In foods, milk as Silymarin (the main • Anticancer damage caused by thistle leaves and active ingredient), is a • Insulin sensitivity support radiation, diabetes, flowers are eaten plant native to Europe and • Anti-inflammatory indigestion as a vegetable and brought to North America • Antilipemic seeds are roasted by early colonists. It is now • Antiviral for use as a coffee found throughout the US. • Hepatoprotective substitute. May be Milk thistle gets its name • Renal protective consumed as tea from the milky sap that is and in supplemental released from the leaves. form as well. The applicable parts of milk thistle are the seeds and above grouind parts. Noni Berry Noni Berry is a tropical fruit • Antioxidant Pain, fatigue, cervical Noni juice, juice of the evergreen tree in the • Anti-inflammatory spondylosis, hypertension, concentrate, Pacific Islands, Southeast • Anti-allergy hyperlipidemia, digestive powder Asia, Australia, and India. It • Analgesic issues, inflammatory skin supplement, dried has been used as an herbal • Antibacterial conditions. fruit powder, teas. remedy. Scientific name • Antifungal It’s often found in Morinda citrifolia. Common • Antihypertensive combination with names: noni, morinda, • Gastrointestinal function grape juice. Indian mulberry, hog apple, • Anti-viral canarywood. It contains high • Anti-lipemic amounts of potassium. • Anti-cancer • Immune support 35 • Neuroprotective Botanicals & Phytonutrients Tested in the APA

Botanical/ Description Potential Beneficial May be useful for Sources Phytonutrient Properties prevention/treatment of Piperine Piperine is the major bio- • Antibacterial • Diabetes supplemental from- active component of black • Blood glucose support • Vitiligo capsules, tablets. pepper. • Antifungal • Cognitive decline Essential oils. • Antioxidation • Overweight/Obesity • Antiparasitic • Parasitic infection • Anticancer • Nutrient bioavailability • Diuretic enhancement • Cognitive Support • GI Support/Antiflatulent • Hepatoprotective • Insecticidal • Metabolic Support Pomegranate Pomegranate is a small • Analgesic Atherosclerosis, CHD, pomegranate is tree cultivated around the • Antiallergic athletic performance, available fresh, in world. It has been used for • Antiatherogenic Alzheimer’s disease, juice, as an extract, thousands of years in many • Anticoagulant candidiasis, dental plaque, powder, tea, or in cultures as a folk medicine. • Antidiarrheal periodontitis, diabetes, supplement capsule Pomegranate holds a variety • Antimicrobial, antibacterial, metabolic syndrome, forms. of phytonutrients with antifungal, antiviral ESRD, erectile dysfunction, potential antioxidant effects. • Anti-inflammatory hyperlipidemia, All applicable parts of the • Anti-cancer hypertension, menopausal pomegranate linked to health • Antioxidant symptoms, PCOS, prostate benefits include the fruit, • Anti-obesity cancer, RA fruit juice, seeds, seed oil, • Athletic performance bark, ring, root, stem, leaf, • Bone and skin health and flower • Hypotensive • Hypoglycemic • Immune support • Neuroprotective • Wound healing Pycnogenol Pycnogenol is an extract • Antioxidation allergic rhinitis, antiplatelet, supplemental form from the bark of a pine tree • Anti-inflammatory asthma, chronic venous or consumed as a that grows along the coast of • Anti-allergic insufficiency, cognitive “brew” southwest France. • Anti-arthritic function, retinopathy, • Anti-asthmatic ADHD, cognitive • Anti-cancer decline, common cold, • Glucose regulation coronary artery disease, • Antimicrobial neuropathy, edema, • Antiviral erectile dysfunction, • Sun protection hyperlipidemia, Meniere’s • Liver protection disease, menopausal • Immune support symptoms, metabolic • Energy Metabolism syndrome, obesity, psoriasis, SLE, and varicose veins Quercetin Quercetin is an antioxidant • Antioxidation obesity, CVD, allergic capers, onions, that belongs to a class • Inhibition of histamine rhinitis, Meniere’s disease, elderberries, kale, of water-soluble plant release, anti-allergy diabetes, interstitial cystitis, okra, radicchio, substances called flavonoids, • Enhancement of capillary and prostatitis watercress, carob which are present in certain tissue integrity fiber, dill weed, fruits and vegetables. • Certain cancer risk reduction radish leaves, apple • Anti-inflammatory peel, asparagus, goji • Antiviral berries • Immune support • Glucose regulation • Inhibition of AGE formation 36 Botanicals & Phytonutrients Tested in the APA

Botanical/ Description Potential Beneficial May be useful for Sources Phytonutrient Properties prevention/treatment of Resveratrol Resveratrol is a naturally • Antioxidation Alzheimer’s, cardiovascular red wine, red grape occurring polyphenol • Anti-aging disease, metabolic skins, purple grape produced by plants to • Anti-cancer syndrome/obesity, juice, mulberries, protect from threats to • Anti-inflammatory diabetes, insulin resistance, peanuts, mulberries, plants’ survival- fungus, • Anti-coagulant cognitive decline, allergic blueberries drought, inflammation, UV • Antiviral rhinitis, certain types of and bilberries, irradiation. • Cardioprotective cancer, and ulcerative eucalyptus, • Liver protection colitis Japanese knotweed, • Immune support and spruce • Neuroprotective • Pulmonary protection • Fat metabolism Rhodiola Root Rhodiola is a flowering herb • Adaptogenic- protection from depression, anxiety, supplemental form- that grows in cold, high- stressors adrenal issues, fatigue, capsules/tablets altitude regions of Europe • Antiaging- reduction in mental performance, and Asia. Other names for it oxidative stress difficulty concentrating, and include Arctic Root, Golden • Antiarrhythmic bladder cancer Root, King's Crown, and • Antibacterial Rose Root. It is considered • Anticancer an adaptogen. It’s applicable • Antidepressant, anti-anxiety, part is the root. mood support • Blood glucose regulation • Blood pressure support, cardio protective support • Anti-inflammatory • Antioxidant • Antiviral • Cognitive support • Immune support Shiitake Mushroom Shiitake mushrooms are • Anti-inflammatory Type 2 diabetes, You can find it edible mushrooms native • Antioxidant cardiovascular disease, fresh, dried or in to East Asia. Research on • Cardiovascular support certain types of cancers, various dietary the compounds in shiitake • Lipid lowering immune issues, and supplements. mushrooms, shows that this • Immune system support hypertension fungus provides many health • Blood glucose regulation benefits. • Tumor inhibition Sulforaphane Sulforaphane is a chemical • Anti-cancer Cancer- particularly cruciferous veggies (isothiocyanate) made during • Antimicrobial (antibiotic) prostate, liver, and (cauliflower, kale, the chewing of cruciferous • Anti -allergic leukemia, H-pylori, cabbage, collards, vegetables, especially • Neurological support cardiovascular disease brussel sprouts, broccoli and broccoli sprouts. • Respiratory support radish, mustard) Sulforaphane is produced • Cardioprotective especially broccoli when glucoraphanin, a • Antioxidant and broccoli constituent of cruciferous • Anti-inflammatory sprouts vegetables, interacts with • Detoxification support- phase myrosinase, an enzyme that 2 occurs naturally in these plants and in human gut microbiota.

37 Botanicals & Phytonutrients Tested in the APA

Botanical/ Description Potential Beneficial May be useful for Sources Phytonutrient Properties prevention/treatment of Turmeric Turmeric, a plant related • Anti-inflammatory arthritis, joint pain, Turmeric is a to ginger, has been used • Antioxidation diabetes, digestive common spice in Ayurvedic medicine for • Antibacterial conditions- IBS, IBD, and a major many conditions including • Antiseptic obesity, age-related ingredient in curry breathing problems, pain, • Interference with cancer cell cognitive decline, powder. Turmeric’s and fatigue. It is a common signaling depression, high underground spice and a major ingredient • Blood glucose regulation triglyceride blood levels, stems are dried in curry powder. • Fat metabolism rheumatoid arthritis, and and made into • Wound healing certain types of cancer capsules, tablets, teas, powders, and extracts. Turmeric powder can also be made into a paste for skin issues. Wild Cherry Bark Wild cherry is a tree native • Antioxidant Although commonly used Most commonly to North and South America. • Reduction in blood pressure for bronchitis, colds, cough, found in syrup The bark and the fruit is used • Sedative effect and diarrhea, there is formulas. Also in to make medicine. • Anti-inflammatory insufficient information teas/extracts. • Respiratory support, cough available about the suppressant effectiveness of wild cherry Zeaxanthin Zeaxanthin is one of two • Antioxidant AMD, degenerative spinach, kale, major carotenoids (and • Antibacterial eye disease, retinitis dark green leafy lutein) found as a color pigmentosa, and visual vegetables, egg pigment in the human eye. It impairment yolks, corn, grapes, accumulates in the macular oranges, squash, region of the retina where and zucchini it exerts a protective effect by filtering the phototoxic glue-light portion of the sun’s rays. It is the pigment that gives corn, saffron, and many other plants their characteristic color.

IMPORTANT: Identified adverse food reactions- allergies, sensitivities, and intolerances- should be avoided even if these cellular tests have shown those food sources of micronutrients/botanicals to be “beneficial”. The CMA and APA test the responses of B and T lymphocytes, not antibodies (IgE- mediated allergies) or cells of the innate immune system (Alcat Test). Patients and practitioners are encouraged to carefully read all product/supplement labels and avoid all ingredients that are contraindicated for any reason.

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Revised May 2020

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